to begin with i was a minor at the time and they are sending me to collections for visits my insurance was never billed for in 2002. I guess the physical therapy place never mailed the bill to my insurance and now my insurance says it is not their problem they were never billed before and refuse to pay. Am i obligated to pay for the therapist mistake of not billing my insurance?
2007-02-20 08:46:42 · 10 answers · asked by trevino_2 2 in Business & Finance ➔ Insurance
it wasn't that my insurance didn't pay for the bill, but they never received it and even told me that i am not liable for a bill they never received, but i can't get the collection agency off my back about it. I think i'm going to have to hire a lawyer for this one.
2007-02-20 09:04:02 · update #1
in response to dougall18 my insurance had covered my other visits, i had a referrel from my orthopedist, i called my insurance and asked them for the specific dates i was being taken to collections for and they have no record of being billed from my physical therapist. i honestly believe PT never billed my insurance for those days and i don't see how it should be my fault they didn't.
2007-02-20 09:09:42 · update #2
thanks everyone for all the answers this has been very helpful especially those answers from professionals in the field, and as far as my parents "slacking off" this could only happen if we received a bill in the past and my parents refused to pay, however this was not the case and we did not know we were being billed until collections was coming after me. i tried to get a hold of PT and they shut down and are in bankruptcy right now so collections has my record and the only info they will give me is the days in dispute of payment. but i am definitely getting a lawyer for this one once i get a letter in writing from my insurance company saying they are not responsible for billing after the statute of limitations. thanks for your help!!!
2007-02-20 17:18:10 · update #3
*second answer*
Since you were covered for the other visits, it sounds like it is a billing error. The billers are human. They can over look claims if there are consecutive days. I would contact your insurance tomorrow and see what their timely filing limit is. Most reps are more than happy to call a provider especially when they know that this is a viable case. They are hounded by the providers for payment and this may be some release for them to prove to them although they work for a doctor that does not make them as smart. So make the call. Find the T/F limit and go from there. If the rep is not willing to work with you as some of the other people stated ask for a sup. They may give you the run around but be polite, courteous and just say that you would like the reassurance from someone higher up. No offense to the rep even if the issue is documented. Make it clear that this is a large bill and quite old. Good luck and you mail email me directly if I can be of further assistance.
*original answer*
Here's the thing. If the provider was contracted with your insurance company then they should have a timely filing deadline. Be it 90, 180, or 365 days. If they were contracted then that is the legal binding you are looking for. You will have to do some research on this. First I would contact the insurance company to find out their timely filing deadline and to see if that provider was contracted on the date of service, if you had coverage for that type of service. Depending on the answers there, depends on what you do next. If they were contracted with your insurance then you can call them and let them know what you know and say they can not bill you. Also most insurance companies require an authorization for PT. You may have been required to get a referral as well. Do you have any more information that you are able to share?
2007-02-20 09:00:05 · answer #1 · answered by dougall18 1 · 0⤊ 0⤋
Because the account is in collections, you're going to have a hard time getting someone to work with you.... I'd start with calling the actual office of the physical therapist. Tell them you need help... If they try to refer you to collections, ask to speak with a biller, or an office manager. Let them know you understand they've already sent the account to collections, but the collections people won't bill your insurance company...Explain your insurance company never got a claim, and that they can't pay a bill they don't have... If they don't stop the account, call your insurance company, and ask for help... If the person you speak to does not take the initiative to call the PT or the collection agency, ask to speak with someone else, preferably a supervisor... The people who work for the PT and your insurance company can help you.
Did the therapist say why they didn't bill the claim? Are they accusing you of not providing insurance info?
They shouldn't be trying to collect a debt from you; but to fix it, the PT office will have to pull your account out of collections... And, the insurance will probably need to provide something in writing stating they never received the claim... This is between your insurance and the provider... not you... Good luck!
2007-02-20 12:32:14 · answer #2 · answered by Custo 4 · 0⤊ 0⤋
Is this the first bill you recieved? I mean were they billing all along and never received payment or they just decided to bill you years later? Each insurance company has timely filing guidelines that the physician has to follow if they sign a contract with the insurance company. This can range from 90 days to 15 months. Also, each state has a statue of limitations - meaning if they have bill you within the statue set by your state. Also with you being a Minor you did not sign any type of agreement with the physicians office or the insurance company. It may be best to get a lawyer to get this off your credit report.
2007-02-20 13:47:55 · answer #3 · answered by Nette 5 · 0⤊ 0⤋
It will depend upon who your insurance was through. I think that you have a VERY GOOD CASE to argue the bill. I've worked with Blue Cross Blue Shield for years, and if the provider was participating with them - they have a 3 year time limit for submitting claims.
If the claim is submitted outside of that time frame, BCBS denies it and the provider is simply stuck with it and they CAN'T BILL the patient. I would contact your former insurance company and find out if they have any "time frame" limits like that.
You might also contact your State's Insurance Dept and see if you can pursue filing a complaint against the provider. If the collection action is effecting your credit report - be CERTAIN to write a letter in your own defense explaining from your perspective how this whole mess occurred - and don't back down from them.
I think you have every right to argue with them!!!!!!!!!!!!!!!
2007-02-20 08:54:29 · answer #4 · answered by Shari 2 · 0⤊ 0⤋
The short answer - yes.
Insurance companies will only pay bills submitted within one year of the date of service.
It was up to your parents, since you were a minor at the time, to pay the bill, or be sure the insurance company paid the bill. They slacked off.
However, PROBABLY they guaranteed the payment for service - so I'm thinking maybe you can sic that collection agent on your folks instead.
But the money IS due.
2007-02-20 12:33:36 · answer #5 · answered by Anonymous 7 · 0⤊ 0⤋
If you look through your credit card and checking account statements from July, 2006, and you can't find a record of a payment to your doctor, then there's a strong likelihood that you didn't make the payment. His billing office probably has better things to do than whomp up fake bills. (Sure they can make mistakes, but so can you. So can all of us.) Instead of complaining that they're trying to pry $30 out of you, congratulate yourself on having been able to carry the debt interest-free for more than a year. Paying up is probably the right thing to do ethically, and when you think about preserving your good credit rating, it's certainly the right thing to do pragmatically.
2016-05-23 23:38:47 · answer #6 · answered by Anonymous · 0⤊ 0⤋
I would ask the therapist for proof that they filed with the insurance company before I gave them a penny. If they did, and your insurance didn't cover the treatment, then you do have to pay for it.
2007-02-20 08:49:09 · answer #7 · answered by Blunt Honesty 7 · 0⤊ 0⤋
yes, if your insurance did not cover it. Personally, I woul dnot pay it myself, I would send the bill onto the insurance company or I would contest it with the physical therapist.
2007-02-20 08:49:09 · answer #8 · answered by Anonymous · 0⤊ 0⤋
I would think that 5 years have passed and they had their chance of payment from your parents/guardians back then. I would consult a lawyer.
2007-02-20 08:50:07 · answer #9 · answered by Anonymous · 0⤊ 0⤋
contact your clinics business office and they will guide you on the paper work you will need to fill out to fix this. if they do not then request a copy of your medical records and take them to an attorney. if that does not get them off their butt's to take care of your bill then i dont know what will.
2007-02-20 08:49:57 · answer #10 · answered by colera667 5 · 0⤊ 0⤋